Over recent decades smoking has increasingly become the most high-profile medical bogeyman. Before they can take a single and no doubt deeply satisfying drag, tobacco consumers must now run the gauntlet of eye-watering prices, prophetical messages of doom, explicit medical imagery and social ostracisation.
Twenty years ago the publicised danger was focused on a number of heart and lung conditions and a handful of cancers. Nowadays, you don’t have to dig too deep to discover that the list of conditions for which smoking is an established risk factor has grown exponentially.
So what about CRPS? Is smoking a risk factor for developing the condition? And for those suffering CRPS, can smoking exacerbate the symptoms/spread?
Thirty years ago, based upon data collected between 1978 and 1985, a small-scale study encompassing only 53 patients was published. This concluded that “smoking is statistically linked to” CRPS, with 68% of those in the study diagnosed with CRPS being smokers.
However, as a substantially higher proportion of the population smoked in those days, did coincidence simply skew the data? Interestingly, subsequent studies have failed to reproduce these results. Nevertheless, many in the medical profession, including medical experts in litigation, continue to list smoking as a risk factor, always citing this one, frankly unsatisfactory, study.
Whether or not smoking is a risk factor for developing CRPS, do smokers suffering the condition fair more badly in terms of both their symptoms and the risk of it spreading?
The one specific study on this issue found no relationship between smoking and levels of pain in CRPS. The only positive relationship found was a statistically higher pain-related anxiety score among those with CRPS Type 1 who both smoked and consumed caffeine.
With a dearth of available evidence, I decided to take a sounding direct from a clinical CRPS researcher, who has asked not to be named. They said:
“We actually have no data at all to suggest that stopping smoking actually helps the condition. Stopping smoking does improve wound healing which is independently impaired by CRPS. Therefore, it’s not a good idea to smoke if you suffer from CRPS and are recovering from surgery. However, whilst smoking carries a host of significant health risks of which we are all aware, I cannot say that there is any evidence that smokers with CRPS fair any more badly than non-smokers in terms of the symptoms of CRPS or its spread.”
Of course, in the interest of their overall health smokers should be encouraged to desist. That said, I have seen no persuasive evidence that smoking is either a risk factor per se for CRPS or that smokers with the condition fair more badly than non-smokers.
I though it might be of interest to leave the final words to a client of mine with CRPS, who is also a smoker:
“I only smoke about three a day now on average, sometime one or two more particularly if I’m having a pain flare. That’s a hell of a lot less than I smoked before I had CRPS. I’ve tried to kick it altogether but when I do, on top of everything else, it just makes my stress go through the roof. It really is my little stress reliever. Even my doctor says he can understand that and has stopped nagging me to quit, although I doubt he’d say it officially! It just helps me to cope. To be honest, I really don’t care these days about all the risks of smoking. When you suffer with CRPS, life can’t get much worse anyway.”
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About the author
Leading Complex Regional Pain Syndrome (CRPS) solicitor Richard Lowes co-founded the first legal team in the UK specialising in representing people suffering CRPS and other debilitating chronic pain conditions. Richard is a popular speaker on the subject of chronic pain in litigation and remains an inveterate blogger.